While the STARS air ambulance model has been tried and tested in rural Alberta and other provinces, experts say it would take a significant political push and a hybrid approach to launch in B.C.
Mike Lamacchia, vice president operations for Shock Trauma Air Rescue Service (STARS) in Alberta and Saskatchewan, said it would come down to political will.
“As we’ve done with the Saskatchewan and Manitoba governments, they liked the way the STARS model was implemented in Alberta and they came to us. Only the B.C. government can assess what their needs are,” Lamacchia said. “It has to be at the highest level in the provincial government, they’re the ones who initiate a formal request to STARS, working with their team within the health system to make it happen.”
Lamacchia said his organization is very open to the possibilities and they would build on the best practices they’ve established in other provinces.
“If the province of B.C. came to us and asked to help them understand how the model works, that’s our mandate, to help. That’s what we’re here for. It has to come from them, as an organization we’d be willing to participate in any way that we can help. Our passion is health care in this country. A patient in B.C. or a patient in Alberta is a patient. We need to do our best,” he said.
Lamacchia stressed that preplanning and project timing are the keys to having a system up and running in a relatively short time span.
“If you have the will from the government, and from geopolitical teams across the province, it could be as little as one year to upwards of three years … it depends on the model,” Lamacchia said.
“As with anything you’ve just got to get started. You need energy from both sides — a good dedicated team, a strong commitment from the province, and from the community.”
Lamacchia is responsible for the operation of STARS bases across Alberta and Saskatchewan, as well as the STARS Emergency Link Centre. He said it took many years for the successful STARS model to evolve into what it is today — a world-class integrated health delivery services program with transportation at its core.
“Working closely with the community partners was key. The local 4-H Club and the Lions were big supporters within STARS and places like Hanna and Taber really jumped on board,” Lamacchia said.
“It grew from grassroots, and over time they started to work with the municipality, the provincial government, and created a service agreement with different health regions. They primarily worked with the Calgary health region in a fee-for-service agreement. What really sustained us was the STARS Foundation working with corporate Alberta and the citizens. The energy sector is a huge supporter. There have been many hands that have helped us.”
It all became monumental in 2010 when STARS signed a 10-year service agreement with Alberta Health Services, Lamacchia said.
“As of now, 76 per cent of funding comes from corporate philanthropy and private philanthropy and 24 per cent comes from the province,” he noted. “It’s working and it’s a collaboration. We’re a service provider to Alberta Health and we’re working with their needs. We leave it up to Alberta Health to drive policy and funding, but our mandate for the province is the delivery of care and transport.”
One complicating factor in setting up a full STARS model in B.C. — it isn’t just a template that can be slapped into place in a new province.
“Every provincial jurisdiction has differences in geography, remoteness and small populations,” Lamacchia pointed out.
Executive director of the emergency medical care advocacy group BC HEROS (BC Helicopter Emergency Rescue Operations Society), Hans Dysarsz, agreed but says it could work with a hybrid approach.
“In B.C., due to our topography and existing model — a single service provider for EMS — we would have to create a blended program that is better suited to a B.C. application than an off-the-shelf model used in other jurisdictions. We need a made-in-B.C. medical air rescue program,” Dysarsz said.
Lamacchia said there is an existing set of criteria that needs to be in place before it can happen.
“You’re going to need four distinct checkboxes: There has to be a patient need, you’ve got to have support from the funding side and that connects to the government, you’ve got to have the geopolitical or local municipal government on side, and the fourth is you have to have the people,” Lamacchia said.
A popular misconception is that STARS is just a fleet of red helicopters.
“We’re more than just a helicopter program, we have a very integrated approach,” Lamacchia said.
“We have transport physicians out of three centres and our mandate is to provide referral and advice for all critically ill and injured patients. We ascertain the best mode of transport and the physician support team. A real key part that a lot of people don’t see is that we’re more than the red helicopter, as we also provide a great critical care team.”
Alberta’s funding model is unique, Lamacchia admitted, but he said over time a similar ratio could work in B.C.
“In Alberta, we’re blending support from governments (24 per cent), the business community, and individual donors (76 per cent), and that gives us financial stability as well as the ability to fundraise for excellence,” Lamacchia said.
“Governments at all levels are subject to many economic, political, and community priorities. If we rely exclusively on government funding, we cannot maintain our vital program and keep it cutting edge. The support of our donors fuels our innovation. From medical equipment and procedures to aviation tools like night vision goggles to training aids like human patient simulators — none of this would be possible without investment from the community. We raise $11 million in the STARS lottery per year.”
The grassroots fundraising approach creates ownership in Alberta, Lamacchia said, and this grassroots support would be critical to make it happen in B.C.